How to Assess and Treat ADHD (Children and Adults)
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Steven T.Griggs, Ph.D. A PSYCHOLOGICAL CORPORATION
I have been a practicing psychologist in an outpatient setting for over twenty-nine years. I run into the same issues and problems almost every day (addictions, anxiety, assertiveness, children's behaviors, mood disorders, relationships, self-esteem, guilt, forgiveness, procrastination and ADHD/learning disabilities).
This ebook is about the last subject. In it, I take you through the steps I go through to diagnose and treat ADHD, for both kids and adults. This ebook is my latest, and also the most packed with information. I take you through exactly what I do, step by step in figuring out if you or your child have ADHD. Here's a rought outline of what I cover:
Intro and ADHD test--do this while you are still naive.
Definitions and symptoms--"Classic" ADHD is comprised of two categories: Inattention/Hyperactive-Impulsive. Other variants: Hhyperfocused subtype, Central sensitization subtype, Temporal, Limbic and The Ring subtypes/phenomena, and the newest variant of a variant, the Sluggish Cognitive Tempo (SCT) phenomenon (overlaps with ADHD but may be different...)
Here's some of the ways I think about ADHD: Hypoarousal states, neuron states (excitatory and inhibitory), self-stimulation seeking and their relationship to neurotransmitter functioning.
Here are some ADHD categories. Each is filled with the latest data::
ADHD recognized by four official government agencies.
Demographics: five percent of the population.
Frequency of boys vs. girls, kids vs. adults.
Genetic preponderance and geographic propensities.
ADHD and gradeschool performance; retention rates.
ADHD and family composition.
ADHD and acting out, substance use, medical bills, behavior problems.
Boys vs. girls--different behaviors?
ADHD and differential diagnoses (ODD, OCD, moods and specifically, bipolar disorder).
ADHD--first appearance, which symptoms.
ADHD and the critical first three years of school (KG, first and second grade).
Do kids outgrow this?
ADHD vs. "Normal" behaviors.
Causes of ADHD--Seven categories.
And, here's the heart of this ebook:
Five steps to diagnosing ADHD
1) Clinical Interview.
Choosing the right professional.
Preparing for the interview.
Physical Exam--What questions to prepare for...
Eliminating other possible causes (other illnesses or conditions).
2) Behavior Rating Scale.
How to score and interpret the scores.
3) Differential Diagnostic Testing--Getting an Intelligence Test.
A primer on differentiating learning disabilities.
4) Differential Diagnostic Testing--Getting an Achievement Test.
Learning Disability diagnosed vs. simple ADHD.
5) Differential Diagnostic Testing--Getting a Neurological Test.
Visual evaluation--acuity vs. tracking.
The differential questions of ADHD and childhood bipolar disorder.
ADHD and intelligence--the myths.
Tying all the results together.
"Workarounds" and the impact on test results.
The Hyperfocused Type.
Why I Need a Housekeeper (Personal narrative)
ADHD Theme Song
The rich and famous
Treatments (four major ones, numerous minor ones):
(But first manage sleep, allergies and diet. I tell you how. The list of problem substances in foods: stimulants, food colorings/dyes, flavorings, additives, acidity regulators (pH control agents), anticaking agents, antifoaming agents, bulking agents, modified starches, color retention agents, emulsifiers, flour treatments, reducing agents, enzymes, glazing agents, humectants, tracer gases, preseratives, antioxidants, stabilizers, thickeners, gelling agents, artificial sweeteners. Diet clean ups: dairy, yellow foods, junk foods, fruit juices, chocolate, processed meats, MSG, fried foods, bottom-feeding fish, gluten. The two-week plan. Diet suggestions.)
1) Psychotherapy/Behavior therapy
Externalizing strategies: 4:1 rule, three contingencies of reinforcement, cueing, modeling, shaping, reinforcement schedules, star charts, punishment vs. rewards, task reducing, self-talk, self-monitoring, mindfulness, journaling, cognitive re-framing.
2) Family therapy: symptom containment, scheduling behaviors, family rules, assertiveness, empathy, symptom mapping, stress management.
Parenting Considerations: Breast feeding, sleep, morning routine management, team vs. one-on-one approaches, manipulation, strategic breaks.
General considerations for psychotherapy and family therapy: slow down, uni-focusing, immediacy and here-and-now processing, managing expectations, identifying recurring problems, external ticklers, managing transitions, using props, creating routines, organizing, homework tips, homework tracking, clarity/consistency, garnering attention, praise/reward criteria, love, enjoyment, task immersion, safe environments, ambient sounds, exercise, inside vs. outside activities, non-labeling, maturity assessment, "screen" time policy, personal assistants, best kinds of teachers and schools, special services/grants/programs, cognitive mapping (two kinds), cognitive monitoring, creativity, structured thinking (12 kinds), structured movement.
Other proposed ADHD remedies--Things to think about and/or try before going further:
3) Herbs (ten)
Homeopathic approaches (sample of two products but too many ingredients to count)
Vitamins/supplements (forty plus...)
Stimulants (six chemical classes with eleven variations/brand names)
Non-stimulants (four chemical classes with six variations/brand names)
Appendix C: Further reading and related sources (19) and websites to search (13).
Appendix D: Quotes (funny and profound).
That's my quick outline. This ebook is stuffed...